Table 1

Components of WHO multimodal hand hygiene improvement strategy

1. System changeEnsuring that the necessary infrastructure is in place to allow healthcare workers to practice hand hygiene. This includes two essential elements:
  • access to a safe, continuous water supply as well as to soap and towels

  • readily accessible alcohol-based hand-rub at the point of care

2. Training and educationProviding regular training on the importance of hand hygiene based on the ‘My 5 Moments for Hand Hygiene’ approach, and the correct procedures for hand-rubbing and hand-washing, to all healthcare workers
3. Evaluation and feedbackMonitoring hand hygiene practices and infrastructure, along with related perceptions and knowledge among healthcare workers, while providing performance and results feedback to staff
4. Reminders in the workplacePrompting and reminding healthcare workers about the importance of hand hygiene, and about the appropriate indications and procedures for performing it
5. Institutional safety climateCreating an environment and the perceptions that facilitate awareness-raising about patient safety issues, while guaranteeing consideration of hand hygiene improvement as a high priority at all levels, including:
  • active participation at both the institutional and individual levels

  • awareness of individual and institutional capacity to change and improve (self-efficacy)

  • partnership with patients and patient organisations

  • Adapted from ref. 3.